Dietary Factors in the Modulation of Inflammatory Bowel Disease Activity

Shinil Shah, DO, PGY-1

Disclosures

March 27, 2007

Glutamine

Glutamine is sometimes advocated as being beneficial in the management of inflammation. Although not an essential amino acid, glutamine is believed to play a role in the maintenance of the colonic mucosal barrier, and is an energy substrate for colonic cells. It is believed that altered mucosal permeability can foster translocation of colonic flora and/or toxins, contributing and/or initiating an inflammatory response.

However, not all of the studies regarding glutamine show positive benefit in IBD. When administered in a trinitrobenzenesulfonic acid-induced colitis model, there was actually a worsening of intestinal inflammation. Other studies in different models, however, have shown an improvement. As suggested by Akobeng and colleagues,[28] there may be an optimal level of glutamine necessary for improvement; alteration from that level may have deleterious effects.

There are possible reasons why excess glutamine may not serve a beneficial purpose. It is understood that glutamine up-regulates the immune system. Glutamine is also a precursor to nitric oxide. Nitric oxide plays a key role in inflammation and injury and hence may not be beneficial to patients with IBD.[28,29]

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